title: Evaluation of three different surgical approaches in repairing paravaginal support defects: a comparative trial.
abstract: OBJECTIVE
  Paravaginal defects have been shown to account for 60-80% of anterior compartment prolapse and its repair offers the chance of a more effective cure of such defect. There is no good evidence to suggest the superiority of a particular route of paravaginal repair. The objective of this study was to evaluate the effectiveness of abdominal (APVR), vaginal (VPVR) and laparoscopic (LPVR) approaches in the repair of such defects.
  
  
  METHODS
  This is a prospective comparative study of patients, referred over a 2-year period, with symptomatic stage II–IV anterior compartment prolapse due to paravaginal support defects. Patients were assessed subjectively by direct verbal questioning, and objectively, using POP-Q system for staging, at 1, 6 and 12 months postoperatively. Analysis of data was performed using SPSS for Windows (V9) software package.
  
  
  RESULTS
  Forty-five patients were recruited to the study. There was no significant difference in the subjective and objective outcomes of APVR (n = 20) and VPVR (n = 20) groups. The laparoscopic approach had to be abandoned after five patients only, as the degree of improvement in prolapse stage was less than in the other two approaches.
  
  
  CONCLUSIONS
  The effectiveness of paravaginal repair procedure is similar whether the abdominal or vaginal approaches were adopted in patients with anterior compartment prolapse due to paravaginal support defects. In our experience, the laparoscopic approach was associated with the least favourable outcome.
authors.forename: Mohamed M
authors.initials: MM
authors.lastname: Hosni
authors.forename: Alaa E H
authors.initials: AE
authors.lastname: El-Feky
authors.forename: Wael I
authors.initials: WI
authors.lastname: Agur
authors.forename: Essam M
authors.initials: EM
authors.lastname: Khater
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000150:complications / Q000601:surgery*; D014621:Vagina / Q000601:surgery*